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目的探讨肠内、外营养支持对食管癌术后炎症反应及肠道通透性的影响。方法将67例食管癌手术患者分为肠内营养(EN)组37例、肠外营养(PN)组30例,观察2组患者营养指标、急性炎性指标、内毒素水平的变化。结果 2组术后内毒素水平、各项炎性反应指标均明显上升,各项营养指标均较术前明显下降。术后第7天EN组内毒素水平显著低于PN组(P<0.05),血清前白蛋白、转铁蛋白均明显高于PN组(P均<0.05),术后第3、7天的C反应蛋白(CRP)、白细胞介素-6、肿瘤坏死因子-α水平均显著低于PN组(P<0.05)。结论 EN支持安全有效,可有效降低食管癌术后肠黏膜通透性,抑制全身炎症反应。
Objective To investigate the effect of enteral and external nutritional support on postoperative inflammatory response and intestinal permeability of esophageal cancer. Methods Seventy-seven patients with esophageal cancer were divided into enteral nutrition (EN) group (n = 37) and parenteral nutrition group (n = 30). Nutritional indexes, acute inflammatory indexes and endotoxin levels were observed in two groups. Results The postoperative levels of endotoxin and the indexes of inflammatory reaction increased obviously in both groups, and all the nutritional indexes decreased significantly compared with those before operation. The level of endotoxin in EN group was significantly lower than that in PN group on the 7th day (P <0.05), serum prealbumin and transferrin were significantly higher than those in PN group (P <0.05) C-reactive protein (CRP), interleukin-6, tumor necrosis factor-α levels were significantly lower than PN group (P <0.05). Conclusions EN supports safe and effective, which can effectively reduce intestinal mucosal permeability and inhibit systemic inflammatory response after esophagectomy.